Impact of Model for End-Stage Liver Disease allocation system on outcomes of deceased donor liver transplantation: A single-center experience

Han Sang Park,Jeong-Moo Lee,Kwangpyo Hong,Eui Soo Han,Suk Kyun Hong,YoungRok Choi,Nam-Joon Yi,Kwang-Woong Lee,Kyung-Suk Suh 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.3

Backgrounds/Aims: From June of 2016, the Model for End-Stage Liver Disease (MELD)-based allocation system replaced the Child- Turcotte-Pugh (CTP) score-based system for organ allocation liver in Korea. The aim of this study was to analyze changes in outcomes and arising issues before and after the implementation of the MELD system. Methods: From June 2014 to June 2018, 129 patients were selected from recipients who underwent deceased donor liver transplantation (DDLT) in Seoul National University Hospital. Pediatric cases were excluded. According to the allocation system, patients were divided into two groups (52 in the MELD group and 77 in the CTP group). Results: MELD scores of the two groups differed significantly (37.8 ± 2.0 in the MELD group vs. 31.0 ± 8.2 in the CTP group; p = 0.001). The etiology of patients was changed for liver transplantation. The proportion of alcoholic liver cirrhosis increased in the era of the MELD allocation system. However, proportions of hepatitis B related liver cirrhosis and hepatocellular carcinoma were decreased. Six-month mortality rate of the MELD group was 25.0%, which was higher than that (11.7%) of the CTP group (p = 0.022). The 90-day complication rate was significantly higher in the MELD group than in the CTP group (11.5% vs. 2.6%; p = 0.040). Conclusions: When the MELD allocation system was used to distribute livers to severely ill patients, it resulted in poorer outcomes after surgery and higher proportion of alcoholic cirrhosis. Thus, it is necessary to adjust the MELD allocation system so that outcomes after DDLT could be improved.

The Effects of Retinoic Acid and MAPK Inhibitors on Phosphorylation of Smad2/3 Induced by Transforming Growth Factor β1

( Sang Hoon Lee ),( Ju Hye Shin ),( Mi Hwa Shin ),( Young Sam Kim ),( Kyung Soo Chung ),( Joo Han Song ),( Song Yee Kim ),( Eun Young Kim ),( Ji Ye Jung ),( Young Ae Kang ),( Joon Chang ),( Moo Suk Pa 대한결핵 및 호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.1

Background: Transforming growth factor β (TGF-β), retinoic acid (RA), p38 mitogen-activated protein kinase (MAPK), and MEK signaling play critical roles in cell differentiation, proliferation, and apoptosis. We investigated the effect of RA and the role of these signaling molecules on the phosphorylation of Smad2/3 (p-Smad2/3) induced by TGF-β1. Methods: A549 epithelial cells and CCD-11Lu fibroblasts were incubated and stimulated with or without all-trans RA (ATRA) and TGF-β1 and with MAPK or MEK inhibitors. The levels of p-Smad2/3 were analyzed by western blotting. For animal models, we studied three experimental mouse groups: control, bleomycin, and bleomycin+ATRA group. Changes in histopathology, lung injury score, and levels of TGF-β1 and Smad3 were evaluated at 1 and 3 weeks. Results: When A549 cells were pre-stimulated with TGF-β1 prior to RA treatment, RA completely inhibited the p-Smad2/3. However, when A549 cells were pre-treated with RA prior to TGF-β1 stimulation, RA did not completely suppress the p-Smad2/3. When A549 cells were pre-treated with MAPK inhibitor, TGF-β1 failed to phosphorylate Smad2/3. In fibroblasts, p38 MAPK inhibitor suppressed TGF-β1-induced p-Smad2. In a bleomycin-induced lung injury mouse model, RA decreased the expression of TGF-β1 and Smad3 at 1 and 3 weeks. Conclusion: RA had inhibitory effects on the phosphorylation of Smad induced by TGF-β1 in vitro , and RA also decreased the expression of TGF-β1 at 1 and 3 weeks in vivo . Furthermore, pre-treatment with a MAPK inhibitor showed a preventative effect on TGF-β1/Smad phosphorylation in epithelial cells. As a result, a combination of RA and MAPK inhibitors may suppress the TGF-β1-induced lung injury and fibrosis.

The current epidemiological status of infectious coryza and efficacy of PoulShot Coryza in specific pathogen-free chickens

Moo-Sung Han,Jong-Nyeo Kim,전은옥,Hae-Rim Lee,Bon-Sang Koo,Kyeong-Cheol Min,Seung-Baek Lee,Yeon-Ji Bae,Jong-Suk Mo,Sun-Hyung Cho,Hye-Sun Jang,In-PilMo 대한수의학회 2016 Journal of Veterinary Science Vol.17 No.3

Infectious coryza (IC) is an infectious disease caused by Avibacterium (Av.) paragallinarum. IC is known to cause economic losses in the poultry industry via decreased egg production in layers. Between 2012 and 2013, Av. paragallinarum was isolated from seven chicken farms by Chungbuk National University. We identified Av. paragallinarum, the causative pathogen of IC by polymerase chain reaction (PCR) and serovar serotype A, by multiplex PCR. Antibiotic sensitivity tests indicated that a few field-isolated strains showed susceptibility to erythromycin, gentamicin, lincomycin, neomycin, oxytetracycline, spectinomycin, and tylosin. A serological survey was conducted to evaluate the number of flocks that were positive for Av. paragallinarum by utilizing a HI test to determine the existence of serovar A. Serological surveys revealed high positivity rates of 86.4% in 2009, 78.9% in 2010, 70.0% in 2011, and 69.6% in 2012. We also challenged specific pathogen-free chickens with isolated domestic strains, ADL121286 and ADL121500, according to the measured efficacy of the commercial IC vaccine, PoulShot Coryza. We confirmed the effectiveness of the vaccine based on relief of clinical signs and a decreased re-isolation rate of ADL121500 strain. Our results indicate IC is currently prevalent in Korea, and that the commercial vaccine is effective at protecting against field strains.

Mediation effect of herpes zoster derived by statin use on cardiovascular disease risk

Sung-Han Kim,Sung-Cheol Yun,Young-Ho Khang,Min-Chul Kim,Sun Uck Kwon,Gyung-Min Park,Young-Rak Cho,Kwang Min Lee,Moo Hyun Kim 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.5

Background/Aims: Although statins are widely used to reduce the risk of cardiovascular disease (CVD) including stroke and myocardial infarction (MI), it is reported that statin use increases the incidence of herpes zoster (HZ) that is associated with increased risk of CVD. So, we evaluated the mediation effect of HZ caused by statin use on CVD. Methods: We analyzed a prospective cohort from the National Health Insurance Service-database of South Korea. All individuals received a medical check-up and were followed-up from 2002 to 2013. Results: A total of 275,382 individuals > 40 years old were followed up for 11 years from 2003. Of these, 11,415 people (4%) were classified as statin users and 263,967 (96%) as non-statin users. Those who used statins had significantly lower risks of cardiovascular events, stroke, and MI compared with non-statin users; the adjusted hazard ratios in the multivariate analysis were 0.90 (95% confidence interval [CI], 0.82 to 0.98), 0.88 (95% CI, 0.80 to 0.98), and 0.91 (95% CI, 0.79 to 1.07), respectively. When we calculated the mediating effect of cardiovascular events by statin use through HZ, 11.6% of the total beneficial effect of cardiovascular events by statin use was mitigated through the occurrence of HZ caused by statin use. This mediating effect was higher in the younger age group (< 60 years). Conclusions: This study showed that statin use reduced CVD by 10%, but the protective effect of statin use against CVD was mitigated by approximately 10% through the development of HZ caused by statin use.

Evaluation of the Attenuation Rate for Clinical Application of a Flexible Skin Dosimeter in Radiotherapy

Han Moo-Jae,Yang Seung-Woo,Shin Yo-Han,Bae Sang-Il,Moon Young-Min,Jeon Wan,Yu To-Sol,Kang Jin-Kyu,Kim Jin-Young,Heo Seung-Uk,박성광,나정은,Chung Jin Beom 한국물리학회 2020 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.77 No.11

During radiotherapy, some patients owing to the variability in skin sensitivities, may experience adverse skin reactions for doses at which other patients are asymptomatic. Hence, when abnormal symptoms appear on a patient's skin, the etiology should be verified. Accordingly, a surface dosimeter on the skin can help ascertain whether accurate doses are irradiated. Furthermore, surface doses are measured in the field junction gaps during craniospinal irradiation or during large-area radiotherapy to avoid adverse reactions due to cumulative skin doses from multiple beams. However, the point dose measurement errors of surface dosimeters exceed approximately 10% and have low-positional accuracies because the attachment sites are approximated with the help of the naked eye. Moreover, accurate information on field junction gaps cannot be obtained. Therefore, in clinical practice, a flexible array dosimeter is required as it can measure the dose distribution on the body surface by adapting its shape to the body curvatures. In this study, we implemented a flexible array dosimeter and, based on its constituent materials, evaluated the attenuation rate associated with its use. A polyester (PET) film was used as the underlying substrate. HgI2 and PbI2 photoconductors were used for their good performances in films. Furthermore, the measurement accuracy was verified through comparisons with Monte Carlo simulation outcomes. The resulting PET film had an attenuation rate of 2.22% at a 50-μm thickness. At the minimum material thickness of 25 μm, the attenuation rates for HgI2 and PbI2 were 4.69% and 5.72%, respectively. Further research is needed to fabricate HgI2-based digital skin dosimeters with a thickness under 25 μm. Radiation detection and pixel resolution should be evaluated to accurately confirm the field junction gap.

The Korean Academy of Tuberculosis and Respiratory Diseases : Slide Session ; OS-048 : COPD ; Relationship Between Lung Function and Chest X-Ray Findings in Koreans: A Population-Based Study

( Sang Hoon Lee ),( Joo Han Song ),( Kyung Soo Chung ),( Song Yee Kim ),( Eun Young Kim ),( Ji Jung ),( Young Ae Kang ),( Moo Suk Park ),( Se Kyu Kim ),( Joon Chang ),( Young Sam Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Chronic obstructive pulmonary disease (COPD) is a major health problem in many countries, and it is estimated to be the third common cause of death by 2020. However, there are few population-based studies to investigate the chest x-ray fi ndings in patients with COPD. Methods: We investigated the relationship of lung function and chest x-ray fi ndings using Korea National Health and Nutrition Examination Survey data. A total of 45,811 subjects were enrolled from July 2008 to December 2012. 13,602 subjects (5,878 male and 7,724 female) who undertook chest x-ray and PFT were analyzed in this study. Chest x-ray fi ndings were interpreted by one radiologist and four pulmonologists, and these readings were re-checked by six other doctors. Chest x-ray fi ndings are divided by 11 categories. PFT results are classifi ed as normal, obstructive, or restrictive pattern. All data analysis was done by SAS 9.2.Results: 10,342 (76.0%) subjects showed normal lung function; 1,776 (13.1%) obstructive pattern; 1,484 (10.9%) restrictive pattern. Inactive tuberculosis was the most common fi nding (7.9%) in this study. In subjects with airway obstruction, inactive tuberculosis (20.1%) was the most common fi nding and inactive other lung disease (6.3%) was the second. Like subject with obstructive lung pattern, inactive tuberculsis (11.3%) and inactive other lungdieseas (5.5%) were most common in subjects with restrictive lung function. Conclusions: To the best of our knowledge, there were no studies to investigate the association of lung function and chest x-ray fi ndings using population based study. In Korea, 20.1% of subjects with airway obstruction showed inactive tuberculosis on chest x-ray. Inactive tuberculosis and inactive other lung disease were most common chest x-ray fi ndings in both subjects with obstructive and restrictive lung function, but the proportion was different between two groups.

Hydrogen sulfide-producing cystathionine γ-lyase is critical in the progression of kidney fibrosis

Han, Sang Jun,Noh, Mi Ra,Jung, Jung-Min,Ishii, Isao,Yoo, Jeongsoo,Kim, Jee In,Park, Kwon Moo Elsevier 2017 FREE RADICAL BIOLOGY AND MEDICINE Vol.112 No.-

<P><B>Abstract</B></P> <P>Cystathionine γ-lyase (CSE), the last key enzyme of the transsulfuration pathway, is involved in the production of hydrogen sulfide (H<SUB>2</SUB>S) and glutathione (GSH), which regulate redox balance and act as important antioxidant molecules. Impairment of the H<SUB>2</SUB>S- and GSH-mediated antioxidant system is associated with the progression of chronic kidney disease (CKD), characterized by kidney fibrosis and dysfunction. Here, we evaluated the role of CSE in the progression of kidney fibrosis after unilateral ureteral obstruction (UUO) using mice deficient in the <I>Cse</I> gene. UUO of wild-type mice reduced the expression of H<SUB>2</SUB>S-producing enzymes, CSE, cystathionine β-synthase, and 3-mercaptopyruvate sulfurtransferase in the obstructed kidneys, resulting in decreased H<SUB>2</SUB>S and GSH levels. <I>Cse</I> gene deletion lowered H<SUB>2</SUB>S and GSH levels in the kidneys. Deleting the <I>Cse</I> gene exacerbated the decrease in H<SUB>2</SUB>S and GSH levels and increase in superoxide formation and oxidative damage to proteins, lipids, and DNA in the kidneys after UUO, which were accompanied by greater kidney fibrosis, deposition of extracellular matrixes, expression of α-smooth muscle actin, tubular damage, and infiltration of inflammatory cells. Furthermore, <I>Cse</I> gene deletion exacerbated mitochondrial fragmentation and apoptosis of renal tubule cells after UUO. The data provided herein constitute in vivo evidence that <I>Cse</I> deficiency impairs renal the H<SUB>2</SUB>S- and GSH-producing activity and exacerbates UUO-induced kidney fibrosis. These data propose a novel therapeutic approach against CKD by regulating CSE and the transsulfuration pathway.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Ureteral obstruction (UO) impairs H<SUB>2</SUB>S-producing enzymes, CSE, CBS, and 3-MST. </LI> <LI> UO reduces levels of H<SUB>2</SUB>S and GSH in the kidney. </LI> <LI> CSE deletion reduces H<SUB>2</SUB>S and GSH and exacerbates UO-induced those in the kidney. </LI> <LI> CSE deletion worsens oxidative injury and apoptosis, resulting in fibrosis. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Intradural Spinal Cysticercosis: Case Series

Han Joo Lee,Kang Moo Sung,Kim Kyung Hyun 대한말초신경학회 2015 The Nerve Vol.1 No.1

Objective Literature concerning treatment with focus on case presentation, mostly, consists of case reports. In this report, we will present the characteristics of the disease and results of seven cases of spinal Neurocysticercosis (NCC) patients. Methods We retrospectively searched data for eligible patients between 1998 and 2014. Total of seven patients were enrolled, and it referred from pathologic result only. Medical records and images were reviewed for preoperative and postoperative clinical, radiological, and pathological results. All patients were treated with surgical treatment with antibiotics and followed up for 43.1±10.23 months (range, 13-98 months). Results Among seven cases, the pathologic lesion was located in intradural-extramedullary (IDEM) portion in six cases, one case was found in intramedullary (IM) portion. Only 28% (2/7) showed brain involvement with spinal cysticercosis. Preoperative symptoms consisted of motor deficit were found in 57% (4/7), sensory change in 43% (3/7), gait ataxia in 43% (3/7), neurogenic bladder dysfunction in 29% (2/7). With regard to pain syndromes, all patients presented pain, including leg pain in 71% (5/7), and back pain in 43% (3/7). At final follow up, neurologic status after treatment showed complete recovery for 43% (3/7), improvement for 43% (3/7), and unchanged status for 14% (1/7). Conclusion Surgical removal of pathogen showed clinically successful results, therefore early operative treatment should be considered in case of neurologic deficit even it is intradural lesion. Twenty eight percent among the patients with spinal cysticercosis showed concomitant brain lesion, thus, brain exploration should be needed at the time of diagnosis.

Hydrogen sulfide accelerates the recovery of kidney tubules after renal ischemia/reperfusion injury

Han, Sang Jun,Kim, Jee In,Park, Jeen-Woo,Park, Kwon Moo Oxford University Press 2015 Nephrology, dialysis, transplantation Vol.30 No.9

<P><B>Background</B></P><P>Progression of acute kidney injury to chronic kidney disease (CKD) is associated with inadequate recovery of damaged kidney. Hydrogen sulfide (H<SUB>2</SUB>S) regulates a variety of cellular signals involved in cell death, differentiation and proliferation. This study aimed to identify the role of H<SUB>2</SUB>S and its producing enzymes in the recovery of kidney following ischemia/reperfusion (I/R) injury.</P><P><B>Methods</B></P><P>Mice were subjected to 30 min of bilateral renal ischemia. Some mice were administered daily NaHS, an H<SUB>2</SUB>S donor, and propargylglycine (PAG), an inhibitor of the H<SUB>2</SUB>S-producing enzyme cystathionine gamma-lyase (CSE), during the recovery phase. Cell proliferation was assessed via 5′-bromo-2′-deoxyuridine (BrdU) incorporation assay.</P><P><B>Results</B></P><P>Ischemia resulted in decreases in CSE and cystathionine beta-synthase (CBS) expression and activity, and H<SUB>2</SUB>S level in the kidney. These decreases did not return to sham level until 8 days after ischemia when kidney had fibrotic lesions. NaHS administration to I/R-injured mice accelerated the recovery of renal function and tubule morphology, whereas PAG delayed that. Furthermore, PAG increased mortality after ischemia. NaHS administration to I/R-injured mice accelerated tubular cell proliferation, whereas it inhibited interstitial cell proliferation. In addition, NaHS treatment reduced post-I/R superoxide formation, lipid peroxidation, level of GSSG/GSH and Nox4 expression, whereas it increased catalase and MnSOD expression.</P><P><B>Conclusions</B></P><P>Our findings demonstrate that H<SUB>2</SUB>S accelerates the recovery of I/R-induced kidney damage, suggesting that the H<SUB>2</SUB>S-producing transsulfuration pathway plays an important role in kidney repair after acute injury.</P>

Proper Tree Vigor and Crop Load in High Density Planting System for 'Fuji'/M.9 Apple Trees

Moo-Yong Park(박무용),Jeong-Kwan Park(박정관),Sang-Jin Yang(양상진),Hyun-Hee Han(한현희),In-Kyu Kang(강인규),Jae Kyun Byun(변재균) (사)한국생물환경조절학회 2008 생물환경조절학회지 Vol.17 No.4

본 연구는 2001년부터 2003년까지 '후지'/M.9가 재식된 밀식사과원에서 적정 수세와 적정 착과량을 조사하였다. 엽과비는 평균 과중(y=1.715x+205.02, R²=0.66)과 수량(y=-35.156x+5963.7, R²=0.44)에서 고도로 유의한 상관이 있는 것으로 나타났고, 주당엽수와 평균 과중 또한 상관이 있었다. 그러나 착과량에 따른 수체생육, 과실품질 요인중 당도 및 착색도에서는 처리간 차이가 없었다. 격년결실이 발생하지 않으면서 300g 이상의 과실을 생산하는 기준은 엽과비는 55 수준에서 착과량이 주당 약 55~64개의 수준이 적합하였다. '후지'M.9 밀식재배시 성목기의 안정된 수세 기준은 평균 신초장이 20~25㎝, 신초 정지율이 95% 이상 수준을 보여야 되는 것으로 판단되며, 보다 세부적으로는 2차 생장이 거의 발생되지 않으며 과대지 비율은 적어도 20~30% 정도 되어야 할 것으로 판단되었다. Proper tree vigor and crop load were determined for 'Fuji'/M.9 apple trees in high density planting system from 2001 to 2003. Leaf/fruit ratio was highly correlated to mean fruit weight (y = l.715x+205.02, R²=0.66) and yield (y=-35.156x+5963.7, R²=0.4). In addition, there was a significant correlation between the number of leaves per tree and mean fruit weight. However, crop load did not affect tree growth, soluble solids content of fruit, and Hunter a value. To harvest the fruits heavier than 300 g without biennial bearing, it was appropriate to crop 55 to 64 fruits in a tree with 55 leaves per fruit of adult tree. The good indices for proper tree vigor could be 20 to 25 ㎝ of mean shoot length and above 95% of shoot termination rate. Moreover, no secondary growth and 20 to 30% of spur formation could be the indices for highly productive tree vigor.